| NPI | 1770181232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID BURKE BOND Sole Member 360-209-2110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2020-10-15 |